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'''Granulation tissue''' forms when | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Granulation tissue in an infected wound, HE 3.JPG | |||
| Width = | |||
| Caption = Granulation tissue. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = blood vessel rich - '''key element''', proliferation of fibroblasts - '''key element''', inflammation - especially lymphocytes ([[plasma cell]]s common), +/- evidence of erosion/ulceration | |||
| Subtypes = | |||
| LMDDx = [[mucocele]], traumatized [[hemangioma]], [[pyogenic granuloma]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = granular appearance, erythematous | |||
| Grossing = | |||
| Site = [[skin]], [[gastrointestinal tract]], other | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = +/-trauma | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
| Tx = +/-debridement | |||
}} | |||
'''Granulation tissue''' forms when wounds heal. | |||
==Gross== | ==Gross== | ||
*Looks granular, ergo the name ''granulation tissue''. | *Looks granular, ergo the name ''granulation tissue''. | ||
Image | ===Image=== | ||
<gallery> | |||
Image:Finger_with_granulation_tissue.jpg | Granulation. (WC) | |||
</gallery> | |||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*Blood vessel rich - '''key element'''.<ref name=pmid11266270>{{cite journal |author=Howdieshell TR, Callaway D, Webb WL, ''et al.'' |title=Antibody neutralization of vascular endothelial growth factor inhibits wound granulation tissue formation |journal=J. Surg. Res. |volume=96 |issue=2 |pages=173–82 |year=2001 |month=April |pmid=11266270 |doi=10.1006/jsre.2001.6089 |url=}}</ref> | *Blood vessel rich - '''key element'''.<ref name=pmid11266270>{{cite journal |author=Howdieshell TR, Callaway D, Webb WL, ''et al.'' |title=Antibody neutralization of vascular endothelial growth factor inhibits wound granulation tissue formation |journal=J. Surg. Res. |volume=96 |issue=2 |pages=173–82 |year=2001 |month=April |pmid=11266270 |doi=10.1006/jsre.2001.6089 |url=}}</ref> | ||
**Small size | **Small size ~ 25 micrometers in diameter.{{fact}} | ||
*Proliferation of fibroblasts - '''key element'''. | *Proliferation of fibroblasts - '''key element'''. | ||
*Inflammation | *Inflammation - especially lymphocytes. | ||
**[[Plasma cell]]s common. | |||
Images: | DDx: | ||
*[[Mucocele]]. | |||
*[[Pyogenic granuloma]]. | |||
*Traumatized [[hemangioma]]. | |||
*Prolapsed [[fallopian tube]] - rare complication following [[hysterectomy]].<ref>{{Cite journal | last1 = Fan | first1 = QB. | last2 = Liu | first2 = ZF. | last3 = Lang | first3 = JH. | last4 = Sun | first4 = DW. | last5 = Leng | first5 = JH. | last6 = Zhu | first6 = L. | last7 = Ning | first7 = L. | title = Fallopian tube prolapse following hysterectomy. | journal = Chin Med Sci J | volume = 21 | issue = 1 | pages = 20-3 | month = Mar | year = 2006 | doi = | PMID = 16615279 }}</ref> | |||
===Images=== | |||
<gallery> | |||
Granulation tissue in an infected wound, HE 1.JPG | GT. (WC/Patho) | |||
Granulation tissue in an infected wound, HE 2.JPG | GT. (WC/Patho) | |||
Granulation tissue in an infected wound, HE 3.JPG | GT. (WC/Patho) | |||
</gallery> | |||
www: | |||
*[http://oac.med.jhmi.edu/pathconcepts/ShowImage.cfm?TutorialID=8&ConceptID=47&ImageID=127 Granulation tissue with entrapped muscle (jhmi.edu)]. | *[http://oac.med.jhmi.edu/pathconcepts/ShowImage.cfm?TutorialID=8&ConceptID=47&ImageID=127 Granulation tissue with entrapped muscle (jhmi.edu)]. | ||
*[http://www.siumed.edu/~dking2/intro/skinbiop/images/GT1.jpg Granulation tissue (siumed.edu)].<ref>URL: [http://www.siumed.edu/~dking2/intro/inflskin.htm http://www.siumed.edu/~dking2/intro/inflskin.htm]. Accessed on: 17 January 2011.</ref> | *[http://www.siumed.edu/~dking2/intro/skinbiop/images/GT1.jpg Granulation tissue (siumed.edu)].<ref>URL: [http://www.siumed.edu/~dking2/intro/inflskin.htm http://www.siumed.edu/~dking2/intro/inflskin.htm]. Accessed on: 17 January 2011.</ref> | ||
==Sign out== | |||
<pre> | |||
Submitted as "Granulation Tissue - Vaginal", Excision: | |||
- Granulation tissue, see comment. | |||
- NEGATIVE for epithelium. | |||
- NEGATIVE for evidence of malignancy. | |||
Comment: | |||
Clinical correlation and follow-up is recommended. | |||
</pre> | |||
===Block letters=== | |||
<pre> | |||
URINARY BLADDER, BIOPSY: | |||
- REGENERATIVE EPITHELIUM, INFLAMED SUBEPITHELIAL TISSUE AND GRANULATION TISSUE. | |||
- NO MUSCULARIS PROPRIA. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
<pre> | |||
TISSUE, VAGINAL VAULT, BIOPSY: | |||
- GRANULATION TISSUE. | |||
- NEGATIVE FOR FALLOPIAN TUBE. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Micro=== | |||
The sections show vascular tissue with plump fibroblasts, reactive endothelial cells | |||
and a mixed inflammatory infiltrate (granulation tissue). Focally, a dense | |||
cluster of neutrophils is seen at the luminal aspect. | |||
A single layer of epithelium with pale, plump nuclei is present without apparent mitotic | |||
activity. Inflamed subepithelial tissue is present. No stratified urothelium is identified. No significant nuclear atypia is present. | |||
====Alternate==== | |||
The sections show a polypoid fragment of vascular and edematous tissue with a mixed | |||
inflammatory infiltrate consisting of plasma cells, neutrophils and lymphocytes. | |||
No epithelial component is readily identified. No elements of fallopian tube are identified. No significant nuclear atypia is identified. | |||
==See also== | |||
*[[Basics]]. | |||
*[[Cap polyposis]]. | |||
==References== | ==References== | ||